Provider Demographics
NPI:1609387950
Name:DOOLE, JOHN (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:DOOLE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WALDEN DR APT 14
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3890
Mailing Address - Country:US
Mailing Address - Phone:508-654-7346
Mailing Address - Fax:
Practice Address - Street 1:1200 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4318
Practice Address - Country:US
Practice Address - Phone:508-654-7346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZA2600X, 246Y00000X
MA24806183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical
No246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA24806OtherMASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH